|
PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29881
|
| Hospital Charge Code |
29881
|
| Min. Negotiated Rate |
$126.26 |
| Max. Negotiated Rate |
$1,556.75 |
| Rate for Payer: Aetna Commercial |
$722.25
|
| Rate for Payer: Aetna Medicare |
$1,197.50
|
| Rate for Payer: BCBS Complete |
$372.15
|
| Rate for Payer: BCBS Trust/PPO |
$126.26
|
| Rate for Payer: BCN Commercial |
$878.68
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Meridian Medicaid |
$372.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$354.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.61
|
| Rate for Payer: Priority Health Narrow Network |
$839.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$735.17
|
| Rate for Payer: UHC Exchange |
$735.17
|
| Rate for Payer: UHCCP Medicaid |
$354.43
|
|
|
PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Facility
|
OP
|
$2,395.00
|
|
|
Service Code
|
CPT 29881
|
| Hospital Charge Code |
29881
|
| Min. Negotiated Rate |
$1,556.75 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$2,155.50
|
| Rate for Payer: Aetna Medicare |
$3,179.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: ASR ASR |
$2,323.15
|
| Rate for Payer: ASR Commercial |
$2,323.15
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,961.27
|
| Rate for Payer: BCN Commercial |
$1,856.84
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$2,251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,916.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,395.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,323.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$2,155.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,035.75
|
| Rate for Payer: Nomi Health Commercial |
$1,963.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$3,496.90
|
| Rate for Payer: PHP Medicaid |
$1,703.94
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,098.50
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,678.90
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,107.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$4,927.45
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP DNSP |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29881
|
| Min. Negotiated Rate |
$126.26 |
| Max. Negotiated Rate |
$1,556.75 |
| Rate for Payer: Aetna Commercial |
$722.25
|
| Rate for Payer: Aetna Medicare |
$1,197.50
|
| Rate for Payer: BCBS Complete |
$372.15
|
| Rate for Payer: BCBS Trust/PPO |
$126.26
|
| Rate for Payer: BCN Commercial |
$878.68
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Meridian Medicaid |
$372.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$354.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.61
|
| Rate for Payer: Priority Health Narrow Network |
$839.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$735.17
|
| Rate for Payer: UHC Exchange |
$735.17
|
| Rate for Payer: UHCCP Medicaid |
$354.43
|
|
|
PR ARTHRS SUBTALAR JOINT REMOVE LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29904
|
| Min. Negotiated Rate |
$419.61 |
| Max. Negotiated Rate |
$12,622.63 |
| Rate for Payer: Aetna Commercial |
$851.15
|
| Rate for Payer: Aetna Medicare |
$1,197.50
|
| Rate for Payer: BCBS Complete |
$440.59
|
| Rate for Payer: BCBS Trust/PPO |
$12,622.63
|
| Rate for Payer: BCN Commercial |
$941.68
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Meridian Medicaid |
$440.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$990.76
|
| Rate for Payer: Priority Health Narrow Network |
$990.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$716.71
|
| Rate for Payer: UHC Exchange |
$716.71
|
| Rate for Payer: UHCCP Medicaid |
$419.61
|
|
|
PR ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT
|
Professional
|
Both
|
$2,039.00
|
|
|
Service Code
|
HCPCS 29846
|
| Min. Negotiated Rate |
$343.14 |
| Max. Negotiated Rate |
$1,401.05 |
| Rate for Payer: Aetna Commercial |
$696.33
|
| Rate for Payer: Aetna Medicare |
$1,019.50
|
| Rate for Payer: BCBS Complete |
$360.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,401.05
|
| Rate for Payer: BCN Commercial |
$772.60
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Meridian Medicaid |
$360.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$811.12
|
| Rate for Payer: Priority Health Narrow Network |
$811.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.62
|
| Rate for Payer: UHC Exchange |
$590.62
|
| Rate for Payer: UHCCP Medicaid |
$343.14
|
|
|
PR ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$1,225.00
|
|
|
Service Code
|
HCPCS 23044
|
| Min. Negotiated Rate |
$366.57 |
| Max. Negotiated Rate |
$1,094.11 |
| Rate for Payer: Aetna Commercial |
$752.51
|
| Rate for Payer: Aetna Medicare |
$612.50
|
| Rate for Payer: BCBS Complete |
$384.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,094.11
|
| Rate for Payer: BCN Commercial |
$839.55
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Meridian Medicaid |
$384.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$876.76
|
| Rate for Payer: Priority Health Narrow Network |
$876.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$651.18
|
| Rate for Payer: UHC Exchange |
$651.18
|
| Rate for Payer: UHCCP Medicaid |
$366.57
|
|
|
PR ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG
|
Professional
|
Both
|
$805.00
|
|
|
Service Code
|
HCPCS 23101
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$714.95 |
| Rate for Payer: Aetna Commercial |
$609.14
|
| Rate for Payer: Aetna Medicare |
$402.50
|
| Rate for Payer: BCBS Complete |
$316.47
|
| Rate for Payer: BCBS Trust/PPO |
$39.62
|
| Rate for Payer: BCN Commercial |
$677.30
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Meridian Medicaid |
$316.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$301.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$714.95
|
| Rate for Payer: Priority Health Narrow Network |
$714.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$506.98
|
| Rate for Payer: UHC Exchange |
$506.98
|
| Rate for Payer: UHCCP Medicaid |
$301.40
|
|
|
PR ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,127.00
|
|
|
Service Code
|
HCPCS 27620
|
| Min. Negotiated Rate |
$238.79 |
| Max. Negotiated Rate |
$732.55 |
| Rate for Payer: Aetna Commercial |
$598.68
|
| Rate for Payer: Aetna Medicare |
$563.50
|
| Rate for Payer: BCBS Complete |
$308.42
|
| Rate for Payer: BCBS Trust/PPO |
$238.79
|
| Rate for Payer: BCN Commercial |
$652.87
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Meridian Medicaid |
$308.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$694.08
|
| Rate for Payer: Priority Health Narrow Network |
$694.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$524.83
|
| Rate for Payer: UHC Exchange |
$524.83
|
| Rate for Payer: UHCCP Medicaid |
$293.73
|
|
|
PR ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX
|
Professional
|
Both
|
$2,063.00
|
|
|
Service Code
|
HCPCS 24006
|
| Min. Negotiated Rate |
$40.33 |
| Max. Negotiated Rate |
$1,340.95 |
| Rate for Payer: Aetna Commercial |
$949.53
|
| Rate for Payer: Aetna Medicare |
$1,031.50
|
| Rate for Payer: BCBS Complete |
$491.36
|
| Rate for Payer: BCBS Trust/PPO |
$40.33
|
| Rate for Payer: BCN Commercial |
$1,050.17
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Meridian Medicaid |
$491.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,106.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,106.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$809.32
|
| Rate for Payer: UHC Exchange |
$809.32
|
| Rate for Payer: UHCCP Medicaid |
$467.96
|
|
|
PR ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,038.00
|
|
|
Service Code
|
HCPCS 24000
|
| Min. Negotiated Rate |
$21.65 |
| Max. Negotiated Rate |
$1,324.70 |
| Rate for Payer: Aetna Commercial |
$635.11
|
| Rate for Payer: Aetna Medicare |
$1,019.00
|
| Rate for Payer: BCBS Complete |
$331.67
|
| Rate for Payer: BCBS Trust/PPO |
$21.65
|
| Rate for Payer: BCN Commercial |
$708.59
|
| Rate for Payer: Cash Price |
$1,630.40
|
| Rate for Payer: Cash Price |
$1,630.40
|
| Rate for Payer: Meridian Medicaid |
$331.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,324.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$746.50
|
| Rate for Payer: Priority Health Narrow Network |
$746.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$534.56
|
| Rate for Payer: UHC Exchange |
$534.56
|
| Rate for Payer: UHCCP Medicaid |
$315.88
|
|
|
PR ARTHRT ELBOW W/JT EXPL W/WOBX W/O RMVL LOOSE/FB
|
Professional
|
Both
|
$1,348.00
|
|
|
Service Code
|
HCPCS 24101
|
| Min. Negotiated Rate |
$57.31 |
| Max. Negotiated Rate |
$876.20 |
| Rate for Payer: Aetna Commercial |
$670.06
|
| Rate for Payer: Aetna Medicare |
$674.00
|
| Rate for Payer: BCBS Complete |
$348.44
|
| Rate for Payer: BCBS Trust/PPO |
$57.31
|
| Rate for Payer: BCN Commercial |
$747.68
|
| Rate for Payer: Cash Price |
$1,078.40
|
| Rate for Payer: Cash Price |
$1,078.40
|
| Rate for Payer: Meridian Medicaid |
$348.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$784.66
|
| Rate for Payer: Priority Health Narrow Network |
$784.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$561.06
|
| Rate for Payer: UHC Exchange |
$561.06
|
| Rate for Payer: UHCCP Medicaid |
$331.85
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT
|
Professional
|
Both
|
$1,290.00
|
|
|
Service Code
|
HCPCS 26070
|
| Min. Negotiated Rate |
$193.15 |
| Max. Negotiated Rate |
$838.50 |
| Rate for Payer: Aetna Commercial |
$428.74
|
| Rate for Payer: Aetna Medicare |
$645.00
|
| Rate for Payer: BCBS Complete |
$224.77
|
| Rate for Payer: BCBS Trust/PPO |
$193.15
|
| Rate for Payer: BCN Commercial |
$479.88
|
| Rate for Payer: Cash Price |
$1,032.00
|
| Rate for Payer: Cash Price |
$1,032.00
|
| Rate for Payer: Meridian Medicaid |
$224.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$838.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$506.82
|
| Rate for Payer: Priority Health Narrow Network |
$506.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$337.16
|
| Rate for Payer: UHC Exchange |
$337.16
|
| Rate for Payer: UHCCP Medicaid |
$214.07
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA
|
Professional
|
Both
|
$1,089.00
|
|
|
Service Code
|
HCPCS 26080
|
| Min. Negotiated Rate |
$132.87 |
| Max. Negotiated Rate |
$707.85 |
| Rate for Payer: Aetna Commercial |
$525.93
|
| Rate for Payer: Aetna Medicare |
$544.50
|
| Rate for Payer: BCBS Complete |
$277.78
|
| Rate for Payer: BCBS Trust/PPO |
$132.87
|
| Rate for Payer: BCN Commercial |
$592.28
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Meridian Medicaid |
$277.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$625.38
|
| Rate for Payer: Priority Health Narrow Network |
$625.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$426.44
|
| Rate for Payer: UHC Exchange |
$426.44
|
| Rate for Payer: UHCCP Medicaid |
$264.55
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 26075
|
| Min. Negotiated Rate |
$120.56 |
| Max. Negotiated Rate |
$530.74 |
| Rate for Payer: Aetna Commercial |
$447.37
|
| Rate for Payer: Aetna Medicare |
$286.50
|
| Rate for Payer: BCBS Complete |
$235.72
|
| Rate for Payer: BCBS Trust/PPO |
$120.56
|
| Rate for Payer: BCN Commercial |
$503.83
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Meridian Medicaid |
$235.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$530.74
|
| Rate for Payer: Priority Health Narrow Network |
$530.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$355.26
|
| Rate for Payer: UHC Exchange |
$355.26
|
| Rate for Payer: UHCCP Medicaid |
$224.50
|
|
|
PR ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,255.00
|
|
|
Service Code
|
HCPCS 23107
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$1,031.46 |
| Rate for Payer: Aetna Commercial |
$882.97
|
| Rate for Payer: Aetna Medicare |
$627.50
|
| Rate for Payer: BCBS Complete |
$456.92
|
| Rate for Payer: BCBS Trust/PPO |
$24.83
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Meridian Medicaid |
$456.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$815.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,031.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,031.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$750.82
|
| Rate for Payer: UHC Exchange |
$750.82
|
| Rate for Payer: UHCCP Medicaid |
$435.16
|
|
|
PR ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX
|
Professional
|
Both
|
$1,001.00
|
|
|
Service Code
|
HCPCS 23106
|
| Min. Negotiated Rate |
$151.62 |
| Max. Negotiated Rate |
$784.15 |
| Rate for Payer: Aetna Commercial |
$668.25
|
| Rate for Payer: Aetna Medicare |
$500.50
|
| Rate for Payer: BCBS Complete |
$348.00
|
| Rate for Payer: BCBS Trust/PPO |
$151.62
|
| Rate for Payer: BCN Commercial |
$744.75
|
| Rate for Payer: Cash Price |
$800.80
|
| Rate for Payer: Cash Price |
$800.80
|
| Rate for Payer: Meridian Medicaid |
$348.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$650.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$784.15
|
| Rate for Payer: Priority Health Narrow Network |
$784.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$544.60
|
| Rate for Payer: UHC Exchange |
$544.60
|
| Rate for Payer: UHCCP Medicaid |
$331.43
|
|
|
PR ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY
|
Professional
|
Both
|
$1,134.00
|
|
|
Service Code
|
HCPCS 23105
|
| Min. Negotiated Rate |
$85.58 |
| Max. Negotiated Rate |
$995.85 |
| Rate for Payer: Aetna Commercial |
$855.39
|
| Rate for Payer: Aetna Medicare |
$567.00
|
| Rate for Payer: BCBS Complete |
$441.26
|
| Rate for Payer: BCBS Trust/PPO |
$85.58
|
| Rate for Payer: BCN Commercial |
$943.64
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Meridian Medicaid |
$441.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$995.85
|
| Rate for Payer: Priority Health Narrow Network |
$995.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$723.13
|
| Rate for Payer: UHC Exchange |
$723.13
|
| Rate for Payer: UHCCP Medicaid |
$420.25
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$2,691.00
|
|
|
Service Code
|
HCPCS 27310
|
| Min. Negotiated Rate |
$478.82 |
| Max. Negotiated Rate |
$2,115.84 |
| Rate for Payer: Aetna Commercial |
$976.42
|
| Rate for Payer: Aetna Medicare |
$1,345.50
|
| Rate for Payer: BCBS Complete |
$502.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,115.84
|
| Rate for Payer: BCN Commercial |
$1,079.48
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Meridian Medicaid |
$502.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,749.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,134.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,134.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$831.16
|
| Rate for Payer: UHC Exchange |
$831.16
|
| Rate for Payer: UHCCP Medicaid |
$478.82
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$2,691.00
|
|
|
Service Code
|
HCPCS 27310
|
| Hospital Charge Code |
27310
|
| Min. Negotiated Rate |
$478.82 |
| Max. Negotiated Rate |
$2,115.84 |
| Rate for Payer: Aetna Commercial |
$976.42
|
| Rate for Payer: Aetna Medicare |
$1,345.50
|
| Rate for Payer: BCBS Complete |
$502.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,115.84
|
| Rate for Payer: BCN Commercial |
$1,079.48
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Meridian Medicaid |
$502.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,749.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,134.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,134.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$831.16
|
| Rate for Payer: UHC Exchange |
$831.16
|
| Rate for Payer: UHCCP Medicaid |
$478.82
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Facility
|
IP
|
$2,691.00
|
|
|
Service Code
|
CPT 27310
|
| Hospital Charge Code |
27310
|
| Min. Negotiated Rate |
$1,749.15 |
| Max. Negotiated Rate |
$2,691.00 |
| Rate for Payer: Aetna Commercial |
$2,421.90
|
| Rate for Payer: ASR ASR |
$2,610.27
|
| Rate for Payer: ASR Commercial |
$2,610.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,192.90
|
| Rate for Payer: BCN Commercial |
$2,086.33
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Cofinity Commercial |
$2,529.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,152.80
|
| Rate for Payer: Healthscope Commercial |
$2,691.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,610.27
|
| Rate for Payer: Mclaren Commercial |
$2,421.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,287.35
|
| Rate for Payer: Nomi Health Commercial |
$2,206.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,749.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,368.08
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Facility
|
OP
|
$2,691.00
|
|
|
Service Code
|
CPT 27310
|
| Hospital Charge Code |
27310
|
| Min. Negotiated Rate |
$1,703.94 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$2,421.90
|
| Rate for Payer: Aetna Medicare |
$3,179.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: ASR ASR |
$2,610.27
|
| Rate for Payer: ASR Commercial |
$2,610.27
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,203.66
|
| Rate for Payer: BCN Commercial |
$2,086.33
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Cofinity Commercial |
$2,529.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,152.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,691.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,610.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$2,421.90
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,287.35
|
| Rate for Payer: Nomi Health Commercial |
$2,206.62
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$3,496.90
|
| Rate for Payer: PHP Medicaid |
$1,703.94
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,749.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,357.85
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,886.39
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,368.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$4,927.45
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP DNSP |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
PR ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB
|
Professional
|
Both
|
$1,749.00
|
|
|
Service Code
|
HCPCS 27331
|
| Min. Negotiated Rate |
$314.81 |
| Max. Negotiated Rate |
$1,191.32 |
| Rate for Payer: Aetna Commercial |
$634.56
|
| Rate for Payer: Aetna Medicare |
$874.50
|
| Rate for Payer: BCBS Complete |
$330.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,191.32
|
| Rate for Payer: BCN Commercial |
$706.63
|
| Rate for Payer: Cash Price |
$1,399.20
|
| Rate for Payer: Cash Price |
$1,399.20
|
| Rate for Payer: Meridian Medicaid |
$330.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$314.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,136.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$743.44
|
| Rate for Payer: Priority Health Narrow Network |
$743.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$534.08
|
| Rate for Payer: UHC Exchange |
$534.08
|
| Rate for Payer: UHCCP Medicaid |
$314.81
|
|
|
PR ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 28052
|
| Min. Negotiated Rate |
$165.93 |
| Max. Negotiated Rate |
$1,658.33 |
| Rate for Payer: Aetna Commercial |
$374.25
|
| Rate for Payer: Aetna Medicare |
$250.00
|
| Rate for Payer: BCBS Complete |
$174.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.33
|
| Rate for Payer: BCN Commercial |
$563.94
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Meridian Medicaid |
$174.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$394.37
|
| Rate for Payer: Priority Health Narrow Network |
$394.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.70
|
| Rate for Payer: UHC Exchange |
$329.70
|
| Rate for Payer: UHCCP Medicaid |
$165.93
|
|
|
PR ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH
|
Professional
|
Both
|
$2,169.00
|
|
|
Service Code
|
HCPCS 27612
|
| Min. Negotiated Rate |
$374.88 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$742.06
|
| Rate for Payer: Aetna Medicare |
$1,084.50
|
| Rate for Payer: BCBS Complete |
$393.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$831.24
|
| Rate for Payer: Cash Price |
$1,735.20
|
| Rate for Payer: Cash Price |
$1,735.20
|
| Rate for Payer: Meridian Medicaid |
$393.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$883.89
|
| Rate for Payer: Priority Health Narrow Network |
$883.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$646.52
|
| Rate for Payer: UHC Exchange |
$646.52
|
| Rate for Payer: UHCCP Medicaid |
$374.88
|
|
|
PR ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$1,888.00
|
|
|
Service Code
|
HCPCS 25040
|
| Min. Negotiated Rate |
$367.43 |
| Max. Negotiated Rate |
$1,227.20 |
| Rate for Payer: Aetna Commercial |
$746.44
|
| Rate for Payer: Aetna Medicare |
$944.00
|
| Rate for Payer: BCBS Complete |
$385.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,197.13
|
| Rate for Payer: BCN Commercial |
$826.36
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Meridian Medicaid |
$385.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$868.11
|
| Rate for Payer: Priority Health Narrow Network |
$868.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$644.53
|
| Rate for Payer: UHC Exchange |
$644.53
|
| Rate for Payer: UHCCP Medicaid |
$367.43
|
|
